title: Gender differences in substance abuse treatment and barriers to care among persons with substance use disorders with and without comorbid major depression.
abstract: OBJECTIVE
  To compare substance use disorders (SUD) treatment patterns and barriers to such treatment among men and women with SUD with and without comorbid major depressive episodes (MDE) in a community sample.
  
  
  METHODS
  Using data from adult participants in the National Survey on Drug Use and Health 2005-2010, we investigated differences by sex in the association of MDE comorbidity with SUD on patterns of, perceived unmet need for, and the perceived barriers to SUD treatments.
  
  
  RESULTS
  Compared with participants with SUD without MDE, both men and women with comorbid SUD and MDE were more likely to use SUD services or to report an unmet need for such treatment. Sex modified the association of comorbidity and treatment patterns: males with MDE comorbidity had a greater likelihood of emergency room visits and use of inpatient services than females. Barriers to substance treatment were remarkably similar for males and females in both the SUD without MDE group and with MDE group, with attitudinal factors being the most common barriers.
  
  
  CONCLUSIONS
  Comorbidity with MDE seems to be an important predictor of service utilization and perceived need for SUD treatment in both men and women. The association of comorbidity with the use of some types of services, however, seems to vary according to sex. The findings have implications for the design of sex-specific SUD treatment programs.
authors.affiliation: From the Departments of Mental Health (LYC, RMC, and RM) and Epidemiology (RMC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and Department of Psychiatry and Behavioral Sciences (ECS, RMC, and RM), Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Chen
authors.forename: Eric C
authors.initials: EC
authors.lastname: Strain
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Crum
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
mesh_terms: D000328:Adult; D003144:Communication Barriers; D003156:Community Mental Health Services / Q000379:methods / Q000706:statistics & numerical data; D015897:Comorbidity; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D014481:United States / Q000453:epidemiology